Evaluation of a needle disinfectant technique to reduce infection-related hospitalization following transrectal prostate biopsy

To determine whether a needle disinfectant technique during transrectal prostate biopsy is associated with lower rates of infection-related hospitalization.

We conducted a retrospective analysis of all transrectal prostate biopsies performed across the Michigan Urological Surgery Improvement Collaborative (MUSIC) from January 2012 through March 2015. Natural variation in technique allowed us to evaluate for differences in infection-related hospitalizations based on whether or not a needle disinfectant technique was utilized. The disinfectant technique was an intra-procedural step to cleanse the biopsy needle with antibacterial solution after each core was sampled (i.e., 10% formalin or 70% isopropyl alcohol). After grouping biopsies according to whether or not the procedure included a needle disinfectant step, we compared the rate of infection-related hospitalizations within 30 days of biopsy. Generalized estimating equation (GEE) models were fit to adjust for potential confounders.

During the evaluated period, 17,954 biopsies were performed with 5,321 (29.6%) including a disinfectant technique. The observed rate of infection-related hospitalization was lower when a disinfectant technique was utilized at biopsy (0.60% vs. 0.90% without disinfectant technique, p=0.04). After accounting for differences between groups the adjusted hospitalization rate in the disinfectant group was 0.85% (vs. 1.12%), (adjusted OR 0.76, 95% CI 0.50 -1.15, p= 0.19).

In this observational analysis, hospitalizations for infectious complications were less common when the procedure included a needle disinfection technique. However, after adjusting for potential confounders the impact of needle disinfection was not statistically significant. Prospective evaluation is warranted to determine if this step provides a scalable and effective method to minimize infectious complications. This article is protected by copyright. All rights reserved.

BJU international. 2017 Aug 10 [Epub ahead of print]

Gregory B Auffenberg, Ji Qi, Yuqing Gao, David C Miller, Zaojun Ye, Andrew Brachulis, Susan Linsell, Tejal N Gandhi, David Kraklau, James E Montie, Khurshid R Ghani, Michigan Urological Surgery Improvement Collaborative

Department of Urology, University of Michigan, Ann Arbor, MI., Division of Infectious Diseases, Department of Medicine, University of Michigan, Ann Arbor, MI., Lakeside Urology, St. Joseph, MI.

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